Abstract
The microstructural characteristics of white and gray matter in mild cognitive impairment (MCI) and the early-stage of Alzheimer’s disease (AD) remain unclear. This study aimed to systematically identify the microstructural damages of MCI/AD in studies using neurite orientation dispersion and density imaging (NODDI), and explore their correlations with cognitive performance. Multiple databases were searched for eligible studies. The 10 eligible NODDI studies were finally included. Patients with MCI/AD showed overall significant reductions in neurite density index (NDI) of specific white matter structures in bilateral hemispheres (left hemisphere: -0.40 [-0.53, -0.27], P < 0.001; right: -0.33 [-0.47, -0.19], P < 0.001), involving the bilateral superior longitudinal fasciculus (SLF), uncinate fasciculus (UF), the left posterior thalamic radiation (PTR), and the left cingulum. White matter regions exhibited significant increased orientation dispersion index (ODI) (left: 0.25 [0.02, 0.48], P < 0.05; right: 0.27 [0.07, 0.46], P < 0.05), including the left cingulum, the right UF, and the bilateral parahippocampal cingulum (PHC), and PTR. Additionally, the ODI of gray matter showed significant reduction in bilateral hippocampi (left: -0.97 [-1.42, -0.51], P < 0.001; right: -0.90 [-1.35, -0.45], P < 0.001). The cognitive performance in MCI/AD was significantly associated with NDI (r = 0.50, P < 0.001). Our findings highlight the microstructural changes in MCI/AD were characterized by decreased fiber orientation dispersion in the hippocampus, and decreased neurite density and increased fiber orientation dispersion in specific white matter tracts, including the cingulum, UF, and PTR. Moreover, the decreased NDI may indicate the declined cognitive level of MCI/AD patients.
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Acknowledgements
We would like to thank all authors of the studies included in the meta-analysis for use their data and coordinates.
Funding
This study was supported by grants from the Medical and Health Science and Technology Project of Zhejiang Province (Grant No. 2022KY067), the National Natural Science Foundation of China (Grant No. 82272592) and Zhejiang Provincial Traditional Chinese Medicine Science Plan (Grant No. 2020ZB028).
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SZ, JL, JZ, CL, QY and XY contributed to the study conception and design. SZ, JL and JZ conducted the systematic literature search and selected studies for inclusion. SZ, JL, LZ, ZS, CL, QY, YS, XY and JZ participated in data collection, analysis, and interpretation. SZ, JL, KM, LC made the figures. SZ and JL wrote the first draft. YS and JZ obtained funding. All authors provided critical revisions to the report for intellectual content. All authors have seen and approved the final draft.
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Zhong, S., Lou, J., Ma, K. et al. Disentangling in-vivo microstructural changes of white and gray matter in mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. Brain Imaging and Behavior 17, 764–777 (2023). https://doi.org/10.1007/s11682-023-00805-2
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DOI: https://doi.org/10.1007/s11682-023-00805-2